Epidemiology, treatment, and mortality of 3973 scapula fractures from the Swedish fracture register.

ABSTRACT

BACKGROUND: Scapula fractures are relatively uncommon, accounting for <1% of all fractures and approximately 3%-5% of shoulder girdle fractures. This study comprehensively describes the epidemiology, fracture classification, treatment, and mortality associated with scapula fractures within a large adult Swedish population. METHODS: This observational study included all patients ≥ 18 years old at the time of injury with a scapula fracture (ICD S42.1) registered in the Swedish Fracture Register between March 2011 and June 2020. Variables studied were age, sex, and injury mechanism, including energy level, fracture classification, associated fractures, treatment, and mortality. RESULTS: We included 3930 patients (mean age 58 years, standard deviation 18, 64% men) with 3973 scapula fractures. Some 22% of the fractures were caused by high-energy trauma and 21% had at least 1 associated fracture. High energy-injuries were most common in glenoid neck (44%) and scapular body (35%) fractures. However, same-level falls were the most common cause of glenoid rim (62%) and intra-articular glenoid (55%) fractures. Clavicle fractures (9%) and proximal humerus fractures (5%) were the most commonly associated fractures. The most common fracture types were the glenoid rim (n = 1289, 32%) and scapular body (n = 1098, 28%) fractures. Nonoperative treatment was performed in 81% of patients. Glenoid rim and intra-articular glenoid fractures were treated operatively in over 30% of cases. The mortality rate for the whole cohort was 4% at 1 year. CONCLUSIONS: Scapula fractures are predominately sustained by men. High energetic injuries and associated fractures are present in 1 in five patients. Nonoperative treatment is chosen in 4 of five patients, but for some fracture types 1 in 3 undergo surgery.